Testing a Brief Reassurance Message Before a Musculoskeletal Clinic Visit

Randomized Controlled Trial of a Nudge Intervention for Common Musculoskeletal Conditions

The goal of this clinical trial is to learn if a brief, reassuring pre-visit message affects patients' expectations and planned follow-up care in adults with common musculoskeletal conditions. The main questions it aims to answer are:

• Does reading a brief reassurance message before a clinic visit change how interested patients are in additional care, such as follow-up visits, tests, injections, or surgery?
• Does the message affect whether patients actually schedule follow-up care after the visit?

Researchers will compare participants who receive the pre-visit reassurance message to those who receive usual care to see if the message changes patients' enthusiasm for care or their follow-up decisions.

Participants will:

1. Read a short, easy-to-understand message about musculoskeletal symptoms and options for care (for those in the intervention group)
2. Complete a brief questionnaire rating their interest in follow-up visits, tests, injections, or surgery
3. Have their scheduled follow-up care recorded after the clinic visit

Study Overview

• Status: Not yet recruiting
• Conditions: Any Non-traumatic Musculoskeletal Condition
• Intervention / Treatment: Behavioral: Nudge intervention

• Study Type: Interventional
• Enrollment (Estimated): 144
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: David Ring, MD, PhD; Phone Number: (833) 882-2737; Email: david.ring@austin.utexas.edu

Study Locations

• United States
  • Texas
    • Austin, Texas, United States, 78712
      • Musculoskeletal Institute, UT Health Austin
      • Contact: David Ring, MD, PhD; Phone Number: (833) 882-2737; Email: david.ring@austin.utexas.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adult (18+ years)
• English or Spanish language literacy
• Seeking musculoskeletal specialty care
• Diagnosed with any non-traumatic musculoskeletal condition
• New or return patient to clinic

Exclusion Criteria:

• Cognitive or other impairment precluding completion of a survey on a tablet
• Acute traumatic pathophysiology (fracture, dislocation, sprain/strain)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Arm (Nudge / Reassurance Message); Participants randomized to the intervention group will read a brief, easy-to-understand message (generated by a Large Language Model) before their musculoskeletal clinic visit. The message explains that many musculoskeletal symptoms are common, often related to normal body changes, and can improve with simple self-care. It emphasizes that visits, tests, injections, and treatments are often optional, and patients can decide how much care they wish to pursue. After reading the message, participants will complete a short questionnaire rating their interest in follow-up visits, tests, injections, and surgery. Clinicians providing care will be blinded to participants' group assignment.	Behavioral: Nudge intervention; The intervention involves reading a brief, easy-to-understand message prior to a musculoskeletal clinic visit. The message explains that many musculoskeletal symptoms are common, often related to normal age-related changes, and can improve with simple self-care. It emphasizes that visits, tests, injections, and treatments are often optional, and patients can choose how much care to pursue.; Other Names: Reassurance message
No Intervention: Control arm (Usual Care); Participants randomized to the control group will receive usual care prior to their musculoskeletal clinic visit, without any pre-visit reassurance message. They will complete the same questionnaire rating their interest in follow-up visits, tests, injections, and surgery. Clinicians providing care will be blinded to participants' group assignment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pre-visit enthusiasm for additional care	The primary outcome is pre-visit enthusiasm for additional care, measured as participants' self-reported interest in pursuing a return visit, diagnostic tests, physical therapy, injections, or surgery. Participants rate each item on a 0-10 scale, where 0 indicates "not at all interested" and 10 indicates "definitely want it." This outcome is assessed immediately after the intervention (or usual care) and before the clinic visit.	Immediately after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Actual scheduled follow-up care	The secondary outcomes are actual scheduled follow-up care after the musculoskeletal clinic visit, including return visits, diagnostic tests, physical therapy, injections, and surgery. These outcomes are recorded as yes/no for each type of care and are collected from the patient's medical record after the visit.	Immediately following clinic visit

Collaborators and Investigators

• Sponsor: University of Texas at Austin

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2026
• Primary Completion (Estimated): March 31, 2026
• Study Completion (Estimated): July 31, 2026

Study Registration Dates

• First Submitted: December 15, 2025
• First Submitted That Met QC Criteria: January 4, 2026
• First Posted (Actual): January 9, 2026

Study Record Updates

• Last Update Posted (Actual): January 9, 2026
• Last Update Submitted That Met QC Criteria: January 4, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Osteoarthritis; Patient education; Shared decision making; Musculoskeletal; Behavioural intervention; Reassurance; Healthcare utilization; Nudge intervention
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis
• Other Study ID Numbers: STUDY00004831.3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No